Universal Sompo Individual Health Insurance

• Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
• 10,000+ hospitals for cashless treatment
• Claim up to Rs. 55,000 deduction under section 80D**

Universal Sompo is one of the general insurance service providers operating in the country. The company offers insurance service in various domains including health, motor, commerce, etc. Health insurance is one of the major segments of the company, and it continues to compete with various top players in the industry. Universal Sompo Individual Health Insurance is a comprehensive health insurance plan offered by the company. This is an affordable health insurance cover designed for the middle-class population of the country.

Eligibility for Universal Sompo Individual Health Insurance

The following eligibility criteria applies to those who wish to enroll themselves in the Universal Sompo Individual Health Insurance policy:

• The age of the proposer must be between 18 years and 65 years of age.
• Dependent children can be enrolled from the age of 3 months along with their parents.
• This policy offers lifelong renewability option once a person has entered this cover.

Features of Universal Sompo Individual Health Insurance

Some of the notable features of Universal Sompo Individual Health Insurance policy can be listed as follows:

• This policy is available in multiple sum insured options ranging from Rs.1 lakh to Rs.5 lakh.
• Pre-existing medical conditions can be covered under this policy only after 48 months of continuous coverage.
• The initial waiting period for sickness hospitalisation is 30 days from the date of inception of the policy cover.
• For certain conditions like cataract, hysterectomy, benign prostatic hypertrophy, sinusitis, piles, etc., there is a waiting period of 1 year applicable to policyholders.
• Pre-hospitalisation medical expenses incurred for up to 30 days before admission in a hospital are covered by this policy.
• Post hospitalisation medical expenses incurred for up to 60 days after discharge from the hospital are covered by this policy.
• A cumulative bonus of 5% is offered for every claim-free year subject to a maximum of 30% of the sum insured amount.
• For people over the entry age of 45 years, a pre-insurance medical examination is required before enrolling in this policy. The company will not provide any reimbursement for the medical tests undertaken.
• This policy offers tax benefits on the premium charges paid as per the regulations of Section 80D of the Income Tax Act.

Benefits of Universal Sompo Individual Health Insurance

The range of benefits offered by Universal Sompo Individual Health Insurance policy can be listed as follows:

Exclusions of Universal Sompo Individual Health Insurance

The following list of conditions will not be covered by Universal Sompo Individual Health Insurance policy:

• Injuries or illnesses caused by war, invasion, etc.
• Cost of medical aids such as spectacles, contact lens, crutches, hearing aids, etc.
• Self-inflicted injuries or suicide attempt
• Treatment expenses attributable to pregnancy or childbirth
• Dental treatment or surgery unless necessitated by an accident
• Any kind of venereal diseases or sexually transmitted diseases
• Injuries or illnesses caused due to the abuse of alcohol or drugs
• Cosmetic or aesthetic treatments of all kinds
• Expenses related to naturopathy treatment
• Any non-medical expenses incurred during hospital stay

Claim Procedure

Universal Sompo offers both cashless treatment as well as reimbursement claim facility. The company has network tie-ups with over 4,000 hospitals located in different places across the country. You can contact the company’s customer service and intimate them about the claim. Intimation must be provided at least 48 hours ahead of planned hospitalisation and 24 hours within emergency hospitalisation. You can fill out the authorisation form in the network hospital and send it to the insurer. The company will verify the policy details and approve the authorisation request.

Reimbursement claims can be filed after discharge from the hospital. Along with the claim form, you must also provide various documents like policy copy, discharge summary, diagnostic reports, cash memos, medical bills, diagnostic reports, physician certificate, etc. Once the documents are submitted, the company will verify the document before approving the request. Following the approval, the company will reimburse the claim amount to the insured person.